Method and appartus for performing an open, wedge, high tibial osteotomy

• US 20070244487A1
• Filed: 12/01/2006
• Published: 10/18/2007
• Est. Priority Date: 01/31/2005
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Schneider, Robert, Novak, Vincent, Ammann, Kelly, Burns, Ralph
• Granted Patent: US 7,967,823 B2
• Time in Patent Office: Days
• US Class Current: 606/88
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1732 for bone breaking devices
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 2017/1602 Mills
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect

Abstract

Apparatus for performing an open wedge, high tibial osteotomy, the apparatus comprising: a wedge-shaped implant for disposition in a wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least two keys, laterally offset from one another, for disposition in corresponding keyholes formed in the tibia adjacent to the wedge-shaped opening created in the tibia. Apparatus for performing an open wedge, high tibial osteotomy, the apparatus comprising: a wedge-shaped implant for disposition in a wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least two keys, vertically offset from one another, for disposition in corresponding keyholes formed in the tibia adjacent to the wedge-shaped opening created in the tibia, and a shear rib, laterally offset from the at least two keys, for disposition in a corresponding shear rib keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia.

Claims

1. Apparatus for performing an open wedge, high tibial osteotomy, the apparatus comprising:

a wedge-shaped implant for disposition in a wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least two keys, laterally offset from one another, for disposition in corresponding keyholes formed in the tibia adjacent to the wedge-shaped opening created in the tibia.

2. Apparatus according to claim 1 wherein the wedge-shaped implant comprises at least two separate components.

3. Apparatus according to claim 2 wherein the wedge-shaped implant comprises three separate components.

4. Apparatus according to claim 3 wherein the wedge-shaped implant comprises:

a base component;

a posterior component; and

an anterior component.

5. Apparatus according to claim 4 wherein the at least two keys are disposed on the base.

6. Apparatus according to claim 1 wherein each of the at least two keys includes an interior bore for receiving a fixation screw.

7. Apparatus according to claim 6 wherein the interior bore is axially aligned with the longitudinal axis of its host key.

8. Apparatus according to claim 7 wherein the interior bore is angled so as to direct the fixation screw into the adjacent tibia.

9. Apparatus according to claim 1 wherein each of the at least two keys are slotted longitudinally so as to permit expansion when a fixation screw is received by the key.

10. Apparatus according to claim 1 wherein each of at least two keys includes external ribs to facilitate fixation of the keys relative to the key.

11. Apparatus according to claim 10 wherein the external ribs extend longitudinally along the keys.

12. Apparatus according to claim 10 wherein the external ribs extend circumferentially along the keys.

54. Apparatus according to claim 6 wherein each key includes at least two interior bores for receiving a fixation screw therein.

13. A method for performing an open wedge, high tibial osteotomy, the method comprising:

cutting the bone along a cutting plane, with the cut terminating at a boundary line, and forming at least two keyholes in the tibia adjacent to the cut, wherein the two keyholes are laterally offset from one another;

moving the bone on either side of the cut apart so as to form a wedge-like opening in the bone; and

positioning a wedge-shaped implant in the wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least two keys, laterally offset from one another, and further wherein the at least two keys are disposed in the at least two keyholes formed in the tibia.

14. A method according to claim 13 wherein the wedge-shaped implant comprises at least two separate components.

15. A method according to claim 14 wherein the wedge-shaped implant comprises three separate components.

16. A method according to claim 15 wherein the wedge-shaped implant comprises:

a base component;

a posterior component; and

an anterior component.

17. A method according to claim 16 wherein the at least two keys are disposed on the base.

18. A method according to claim 13 wherein each of the at least two keys includes an interior bore for receiving a fixation screw.

19. A method according to claim 18 wherein the interior bore is axially aligned with the longitudinal axis of its host key.

20. A method according to claim 19 wherein the interior bore is angled so as to direct the fixation screw into the adjacent tibia.

21. A method according to claim 13 wherein each of the at least two keys are slotted longitudinally so as to permit expansion when a fixation screw is received by the key.

22. A method according to claim 13 wherein each of at least two keys includes external ribs to facilitate fixation of the keys relative to the key.

23. A method according to claim 22 wherein the external ribs extend longitudinally along the keys.

24. A method according to claim 22 wherein the external ribs extend circumferentially along the keys.

25. A method according to claim 14 wherein the wedge-shaped implant is assembled prior to positioning in the tibia.

26. A method according to claim 14 wherein the wedge-shaped implant is assembled after positioning in the tibia.

55. A method according to claim 18 wherein each key includes at least two interior bores for receiving a fixation screw therein.

27. Apparatus for performing an open wedge, high tibial osteotomy, the apparatus comprising:

a wedge-shaped implant for disposition in a wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least two keys, vertically offset from one another, for disposition in corresponding keyholes formed in the tibia adjacent to the wedge-shaped opening created in the tibia, and a shear rib, laterally offset from the at least two keys, for disposition in a corresponding shear rib keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia.

28. Apparatus according to claim 27 wherein the wedge-shaped implant comprises at least two separate components.

29. Apparatus according to claim 28 wherein the wedge-shaped implant comprises three separate components.

30. Apparatus according to claim 29 wherein the wedge-shaped implant comprises:

a base component;

a posterior component; and

an anterior component.

31. Apparatus according to claim 30 wherein the at least two keys are disposed on the base, and further wherein the shear rib is disposed on the base.

32. Apparatus according to claim 27 wherein each of the at least two keys includes an interior bore for receiving a fixation screw.

33. Apparatus according to claim 32 wherein the interior bore is axially aligned with the longitudinal axis of its host key.

34. Apparatus according to claim 33 wherein the interior bore is angled so as to direct the fixation screw into the adjacent tibia.

35. Apparatus according to claim 27 wherein each of the at least two keys are slotted longitudinally so as to permit expansion when a fixation screw is received by the key.

36. Apparatus according to claim 27 wherein each of at least two keys includes external ribs to facilitate fixation of the keys relative to the key.

37. Apparatus according to claim 36 wherein the external ribs extend longitudinally along the keys.

38. Apparatus according to claim 36 wherein the external ribs extend circumferentially along the keys.

56. Apparatus according to claim 32 wherein each key includes at least two interior bores for receiving a fixation screw therein.

39. A method for performing an open wedge, high tibial osteotomy, the method comprising:

cutting the bone along a cutting plane, with the cut terminating at a boundary line, and forming at least two keyholes in the tibia adjacent to the cut, wherein the two keyholes are vertically offset from one another, and forming a shear rib keyhole in the tibia adjacent to the cut, wherein the shear rib keyhole is laterally offset from the at least two keyholes;

moving the bone on either side of the cut apart so as to form a wedge-like opening in the bone; and

positioning a wedge-shaped implant in the wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least two keys, vertically offset from one another, and a shear rib, laterally offset from the at least two keys, and further wherein the at least two keys are disposed in the at least two keyholes formed in the tibia, and the shear rib is disposed in the shear rib keyhole formed in the tibia.

40. A method according to claim 39 wherein the wedge-shaped implant comprises at least two separate components.

41. A method according to claim 40 wherein the wedge-shaped implant comprises three separate components.

42. A method according to claim 41 wherein the wedge-shaped implant comprises:

a base component;

a posterior component; and

an anterior component.

43. A method according to claim 42 wherein the at least two keys are disposed on the base.

44. A method according to claim 39 wherein each of the at least two keys includes an interior bore for receiving a fixation screw.

45. A method according to claim 44 wherein the interior bore is axially aligned with the longitudinal axis of its host key.

46. A method according to claim 45 wherein the interior bore is angled so as to direct the fixation screw into the adjacent tibia.

47. A method according to claim 39 wherein each of the at least two keys are slotted longitudinally so as to permit expansion when a fixation screw is received by the key.

48. A method according to claim 39 wherein each of at least two keys includes external ribs to facilitate fixation of the keys relative to the key.

49. A method according to claim 48 wherein the external ribs extend longitudinally along the keys.

50. A method according to claim 48 wherein the external ribs extend circumferentially along the keys.

51. A method according to claim 40 wherein the wedge-shaped implant is assembled prior to positioning in the tibia.

52. A method according to claim 40 wherein the wedge-shaped implant is assembled after positioning in the tibia.

57. A method according to claim 44 wherein each key includes at least two interior bores for receiving a fixation screw therein.

53. A shear rib end mill comprising:

a shaft having a distal end and a proximal end, and a relief area formed on the shaft proximal to the distal end;

a cutting edge formed on the shaft distal to relief area, and a flute communicating with the cutting edge and extending into relief area; and

a stop formed on the shaft, proximal to the relief area.